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The HEMO study - where do we go from here?

Jonathan Himmelfarb1

  • 1Division of Nephrology and Renal Transplantation, Maine Medical Center, Portland 04102, USA. himmej@mmc.org

Current Opinion in Nephrology and Hypertension
|October 18, 2003
PubMed
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The large HEMO study found that neither higher dialysis doses nor high-flux dialyzers significantly reduced mortality in maintenance hemodialysis patients. Current practices and alternative strategies are needed to address high morbidity and mortality.

Area of Science:

  • Nephrology
  • Clinical Trials
  • Renal Replacement Therapy

Background:

  • Maintenance hemodialysis patients experience high rates of morbidity and mortality.
  • Optimizing dialysis dose and membrane flux are potential strategies to improve outcomes.
  • The HEMO study is the largest randomized clinical trial in this population.

Purpose of the Study:

  • To analyze the results of the HEMO study.
  • To determine the impact of dialysis dose and dialyzer flux on mortality and morbidity in hemodialysis patients.
  • To inform strategies for reducing adverse outcomes in this population.

Main Methods:

  • Randomized clinical trial with a 2x2 factorial design.
  • Patients assigned to standard or high dose dialysis.

Related Experiment Videos

  • Patients assigned to low flux or high flux dialyzers.

    • Main Results:

    • No significant difference in all-cause mortality between standard and high dialysis dose groups.
    • No significant difference in all-cause mortality between low flux and high flux dialyzer groups.
    • Key secondary outcomes did not differ significantly between treatment groups.

    Conclusions:

    • HEMO study results support current thrice-weekly dialysis guidelines.
    • Results do not support conventional approaches to lower morbidity and mortality.
    • Focus is shifting to increased dialysis time/frequency, phosphate control, and managing cardiovascular risk factors.